In the abyss

February 9, 2017

Small ideas take a lot of words; big ones need just a few. This was a small idea I stumbled upon, and the idea itself is not that important, but what happened, more so, what didn’t is the story. People here in Idaho are dying and Idaho’s US Senators aren’t doing much for us. That’s the real story here.

The Prescription Drug Abuse Prevention Workgroup was started 6 years ago to address the prescription opioid epidemic in our state. Idaho, like all states has a prescription monitoring program (PMP). At one of the workgroup meetings I was made aware of a gap in our state monitoring system. Federally sanctioned methadone treatment programs and Veterans clinics are not required to enter their controlled substance prescriptions into the Idaho PMP.

That means if a veteran is on oxycodone for chronic pain and he comes into the ER wanting something for pain and doesn’t tell the ER doctor he’s taking the VA meds, the doctor can’t see the prescriptions in the system. I know; this has happened to me as an ER doctor.

The reason for this exception lies in federal law. I asked the Director of the Board of Pharmacy about this and his eyes lit up. “Do you want to know about this? I have all the research.” He shared with me the specific US code, some proposed changes from different US Senators over the years. It seems not just the uninsured are dying from lack of action.

Congress isn’t dead yet; but the reaction I got to this small idea from Idaho’s Senators was moribund.

This should have had some traction since the prescription opioid epidemic was in the news so much and it is rampant in our state. I drafted a brief letter on my state senate letterhead describing the issue and asked for a conversation. I was sensitive to party affiliation issues and got a Republican state senator to introduce this idea to our US Senators and sent off the email. That was a year ago.

THREE MONTHS later I got an email reply thanking me and telling me there would be follow up. THREE MONTHS after that I got a call from an intern working with one of the senator’s offices. We had a polite conversation and the intern asked me a bunch of questions that could have been answered if he had read my initial email. Now we are six months later, I am no longer a state senator, and I doubt there will be any action.

Was it a bad idea or that it came from an Idaho Democrat, or is just Washington DC so crippled? I would have appreciated some response either way. Maybe a new administration will invigorate Congress.

I understand that things take time.

I understand that many of the folks with different interests need to be involved, but there is no reason I can understand why Methadone Clinics or VA clinics should not be reporting their prescriptions to a state PMP. In fact, the Virginia Attorney General sent a letter to HHS last spring asking for the same change. Idaho did not sign on to that request, but 31 other states did.